Break Time Vending Services

Thank you for choosing Break Time Vending Services for your office snack & beverage needs. We are excited that you are choosing us and we look forward to serving you. Please take a moment to complete the information below:

Name:

E-mail address:

Phone:

Business Name:

Business Address:

City:

State:

California

Zip:

Business Phone:

Extension:

Mailing Address:

City:

State:

California

Zip:

Estimated start date:

Type of service:

Drink Snack Food

How many people at the location will have access to the machines?

What type of drinks and snacks interest you? (Check all that apply)

Drinks

Coke

Diet Coke

Cherry Coke

Pepsi

Diet Pepsi

Dr. Pepper

Diet Dr. Pepper

Root Beer

Sprite

7-UP

Squirt

Ruby Red Squirt

Mountain Dew

Cactus Cooler

Orange

Hawaiian Punch

Snapple Teas

Snapple Juices

Snapple Energy Drinks

Amp Energy Drink

Red Bull Energy Drink

Starbucks Double Shot

Starbucks Frappachino

Sobie Drinks

Water

Other

Snacks

Candy	Chips & Crackers	Cookies & Breakfast
Almond Joy	Austin Cheese Crackers	Bon Appetite Variety Danish
Baby Ruth	Austin PBttr Crackers	Cloverhill, Blueberry
Butterfinger	Cheetos (Crunchy)	Cloverhill, Butterhorn Danish
Good 'N Plenty	Cheetos - HOT	Cloverhill, Cherry Cheese
Heath Bar	Cheez-Its	Duchess Honey Buns
Hershey's Special Dark	Chex Mix	Famous Amos Cookies
Hershey's with Almonds	Corn Nuts (variety)	Fig Newton’s
Kit Kat, BIG KIT KAT	Dolphin Crackers	Grandma's Choc Chip
M&M, Peanuts	Doritos (Nacho Cheese)	Grandma's Oatmeal
M&M, Plain	Gardetto's Orig. Snack Mix	Grandma's PButtr
Mars	Handy Snacks	Grandma's Soft Mini Choc
Mike & Ike	Lays Regular Chips	Grandma's Vanilla Cookies
Milky Way	Lays Sour Cream & Onion	Mini Oreo Cookies
Milky Way - Dark	Pork Rinds	Pop Tarts (Blueberry)
Mr. Goodbar	Pork Rinds - HOT	Pop Tarts (Cinnamon)
Nestlé’s 100 Grand Bar	Ritz Bits PButtr Sandwich	Pop Tarts (Strawberry)
Nutrageous	Rold Gold Mini Twist Pretzel	Misc.
Pay Day	Flavor Rush Sr. Cream & Onion	Brownies
Reese Sticks	Ruffles Cheddar & Sour Cream	Fruit by the Foot
Reese's Peanut Butter Cups	Flavor Rush BBQ	Fruit Snacks (Slice, Straw)
Rolo	Sun Chips	Granola Bar (Oats & Honey)
Shock Tarts	Sun Chips (Harvest Cheddar)	Little Debbie Oatmeal Pie
Skittles	Nuts & Popcorn	Nutri-Grain, Apple Cinnamon
Skittles Sour	Cracker Jacks	Nutri-Grain, Blueberry
Hot Tamale	David Orig. Sunflower Seeds	Nutri-Grain, Strawberry
Snickers	Kars Cashews	Quaker Chewy (Bfingr Crnch)
Snickers Crunch	Kars Peanuts	Quaker Chewy (Choc Chip)
Sour Patch Kids	Kars Sunflower Seeds	Quaker Chewy (PBChChip)
Starburst	Kars Sweet & Salty	Quaker Chewy (S'mores)
Three Musketeers	P-Nuttles (Butter Toffee)	Rice Krispy Treats
Twix	Popcorn (Act II, Butter)
Twix Peanut Butter	Popcorn (Butter Lovers)
Twizzlers (red)	Trail Mix (Unsalted Mix & Yogurt)
Whatchamacallit
York Peppermint Patty
Gum/Mints
Big Red Gum
Doublemint Gum
Juicy Fruit Gum
Mint-O-Green Mints
Pep-O-Mints
Winterfresh Gum

Please note that the above lists of items are subject to change based on seasonality, availability, and may be
limited based on the type of machine placed at your location.  Please feel free to gives us a call if you have
any questions.

Comments:

Best time and day to contact you:

Name:
E-mail address:
Phone:
Business Name:
Business Address:
City:
State:	California
Zip:
Business Phone:	Extension:
Mailing Address:
City:
State:	California
Zip:
Estimated start date:
Type of service:	Drink Snack Food